What About Seniors Falling?

Falling down is a serious problem for senior citizens. For seniors,  65 years and older, one out of three falls each year. Half of these fall more than once. Seniors fall more often with each decade of life. Women are more likely to fall than men, but men are more likely to sustain a fatal fall injury. These statistics refer to individuals living in the community, not nursing homes.

So says, Adnan Arseven, MD, AGSF, Division of Internal Medicine and Geriatrics at Northwestern Memorial Hospital, speaking before the hospital’s Healthy Transitions Program®.

Dr. Arseven defined falling as “coming to rest inadvertently on the ground or at a lower level.” This is not as a result of loss of consciousness or hazardous conditions, like slipping on ice.

The Centers for Disease Control and Prevention, CDC, said, “Among older adults (those 65 or older), falls are the leading cause of injury death. They are also the most common cause of nonfatal injuries and hospital admissions for trauma.

“In 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments and more than 662,000 of these patients were hospitalized.

“In 2010, the direct medical costs of falls, adjusted for inflation, was $30.0 billion.”

What outcomes are linked to falls?

• Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, or head traumas. These injuries can make it hard to get around or live independently, and increase the risk of early death.
• Falls are the most common cause of traumatic brain injuries (TBI). In 2000, TBI accounted for 46 percent of fatal falls among older adults.
• Most fractures among older adults are caused by falls. The most common are fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm and hand.
• Many people who fall, even if they are not injured, develop a fear of falling. This fear may cause them to limit their activities, which leads to reduced mobility and loss of physical fitness, and in turn increases their actual risk of falling.
• The death rates from falls among older men and women have risen sharply over the past decade.
• In 2009, about 20,400 older adults died from unintentional fall injuries.
• Men are more likely than women to die from a fall.  After taking age into account, the fall death rate in 2009 was 34 percent higher for men than for women.

Falls in the community have the following causes:

Accidents, environment 37 percent
Weakness, balance, gait 12 percent
Drop Attack 11 percent
Dizziness, vertigo 8 percent
Orthostatic hypotension (blood pressure) 5 percent
Acute illness, confusion, drugs, decreased vision 18 percent.
Unknown causes 8 percent.

Risk factors for seniors include: sedative medicine use, cognitive impairment, lower extremity problems, balance and gait impairment and foot problems.

It is important to realize that the risk of falling increases as the number of risk factors (list above) increase.

One thing Dr. Arseven stressed was that if you fall you should call your doctor and talk about it. If you fall twice or more in 12 months you should see your doctor and be checked. These are the kind of preventative measures that can head off a possibly life-threatening situation.

Because more than half of seniors fall in their own homes, he recommended an assessment of the home by a trained professional, either an Occupational Therapist or a Physical Therapist. This would remove or modify hazards, improve lighting and make for the installation of safety devices like grab bars, non-slip mats, raised toilet seats, handrails on stairs.

On the positive side, the doctor said that the number one preventative measure for seniors falling is EXERCISE. He said a customized exercise program should include balance, strengthening and gait training. It should last longer than 12 weeks and be one to three times weekly.

On the subject of vision, he said that it should be assessed and treated if there is a problem. Also, the first time cataracts are removed the risk of falls declines. Finally, new eyeglasses can be problematic. He said bifocals and the progressive lenses expose seniors to falls as they obscure stairs and curbs.

A final positive was his suggestion to include healthy doses of Vitamin D. He said that Vitamin D improves muscle strength, neuromuscular function and reduces fall risk by 22 percent. The minimum dose he recommended is 800 International Units and possibly up to 2000 IU under advice of one’s doctor.

How is your balance? Before you blurt out, “Perfect!” Try these simple static balance tests: Stand up and line your feet up as if walking a tightrope. Can you hold that position for 10 seconds without your trunk swaying or feet shuffling? If not, you may be vulnerable to falling. A second test is standing on one leg for five seconds. Be sure to do each leg. If you did not ace each of these tests, perhaps you should consider a yoga class or something similar that will build up your balance skills.


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Filed under aging, brain, muscles, seniors falling, walking

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